Cleveland Clinic sets the bar for medical transparency

In an era of increasing transparency in the health care sector, the Cleveland Clinic “stands out above” other hospital systems in making progress toward becoming “radically transparent.”

So argues David Whelan, a former Forbes health care writer who's now a grad student in health care administration.

“This summer I spent some time exploring how big teaching hospitals publicly report clinical outcomes to the public,” Mr. Whelan writes. “For a given set of patients, how many live or die? And with what complications? Patients can rarely find this information before getting elective surgery, or when deciding to commit to a given institution for a long-term course of treatment.”

The problem, as Mr. Whelan sees it, is that “there are few short-term incentives for hospitals to be transparent to the public. … Meanwhile, insurers and public programs rarely pay for better outcomes, so they do not build networks that steer patients to quality. Paternalism pervades the entire system, where insurers and providers alike do not trust patients to shop for the best care.”

But the Clinic is an exception to the trend, he writes.

In addition to its excellent quality of care, “something else Cleveland Clinic should be known for is its public outcomes reporting,” according to Mr. Whelan. “Every year since at least 2005, Cleveland Clinic has published 'Outcomes Books' on its website. For each clinical category it releases data on mortality, complication rates, and patient satisfaction. It also mails paper copies of these books to specialists around the country as a kind of transparency-marketing. No other hospital system comes close to reporting this level of detail about the quality of its care.”

Among his other thoughts on the Clinic's transparency efforts:

“The extent of Cleveland Clinic's reporting is unique in the industry and must be very costly to the institution. The context might provide an explanation. … The organization has grown by providing high-quality medicine that attracts patients nationally and internationally, especially Canadians and Middle Easterners. It would be interesting to know how much outcomes reporting play a role here.”

Outcomes reporting “is a great service to the public but right now it's so ahead of the curve that it's hard to use.” For instance, the Clinic reports a 70% five-year survival rate for stage IV carcinoma of the tongue. “It's difficult to objectively put that in context since few other hospitals do not report the same information,” Mr. Whelan writes.

“Cleveland Clinic and several other major institutions chose to stop reporting to Leapfrog last year, citing the burden of reporting to other sources. The lesson here is that there will be some jostling about who's in control. And Leapfrog, which never excelled at packaging the data it collected, lost out.”
Found money

There are many fun anecdotes in this Bloomberg story about Karl Rove's super PAC efforts on behalf of the Republican Party, and one of the better stories concerns Ohio.

Mr. Rove is using his super PAC, American Crossroads, to flood the political system with money.

Given the political climate and changes in campaign finance law, it doesn't sound very difficult.

“As for the closely watched (Senate) race in Ohio, one of the states that has generated the most political spending by outside groups like American Crossroads, Rove said that he'd had a call from an unnamed out-of-state donor who told him, “I really like Josh Mandel,” referring to the Ohio treasurer attempting to unseat Democrat Sherrod Brown,” Bloomberg reports.

The donor, Mr. Rove tells Bloomberg, had asked him what his budget was in the state; Rove told him $6 million.

“'I'll give 'ya a $3 million, matching challenge,'” Mr. Rove said the donor told him. “Bob Castellini, owner of the Cincinnati Reds, is helping raise the other $3 million for that one.”

If you want to know more than that, unfortunately, you'd need to be a subscriber. I'm not. But it's still pretty intriguing.

In its statement on the survey, Jones Day notes this is the second time it was named to the Fearsome Foursome. It also was named a “Litigation Powerhouse" in intellectual property, securities and finance, and complex commercial litigation.